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뇌척수액 신경잔섬유 가벼운사슬의 호전을 보이는 성인 척수근위축증 3a형 증례: 실사용 근거

A Case of Spinal Muscular Atrophy Type 3a Showing Improvement in Neurofilament Light Chain of Cerebrospinal Fluid: Real-world Evidence

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초록

A 38-year-old male was diagnosed with spinal muscular atrophy (SMA) type 3a, previously misdiagnosed as muscular dystrophy. He began treatment with nusinersen after getting approval from health insurance service. Cerebrospinal fluid (CSF) was collected when nusinersen was intrathecally injected. We measured the neurofilament light chain (NfL) level using a single molecular array as an efficacy biomarker. The CSF NfL level was markedly decreased after finishing the loading dosage. Our case implies that nusinersen is also effective in adults with SMA as a biomarker from real-world evidence.

Abstract

A 38-year-old male was diagnosed with spinal muscular atrophy (SMA) type 3a, previously misdiagnosed as muscular dystrophy. He began treatment with nusinersen after getting approval from health insurance service. Cerebrospinal fluid (CSF) was collected when nusinersen was intrathecally injected. We measured the neurofilament light chain (NfL) level using a single molecular array as an efficacy biomarker. The CSF NfL level was markedly decreased after finishing the loading dosage. Our case implies that nusinersen is also effective in adults with SMA as a biomarker from real-world evidence.

참고문헌 (11)

  1. Gaetani L, "Neurofilament light chain as a biomarker in neurological disorders", J Neurol Neurosurg Psychiatry, 90, pp.870~881 (2019)
  2. Darras BT, "Neurofilament as a potential biomarker for spinal muscular atrophy", Ann Clin Transl Neurol, 6, pp.932~944 (2019)
  3. Alves CRR, "Implications of circulating neurofilaments for spinal muscular atrophy treatment early in life : a case series", Mol Ther Methods Clin Dev, 23, pp.524~538 (2021)
  4. "A study to assess the efficacy and safety of nusinersen (ISIS 396443) in infants with spinal muscular atrophy (ENDEAR)"[URL]
  5. "A study to assess the efficacy and safety of nusinersen (ISIS 396443) in participants with later-onset spinal muscular atrophy (SMA) (CHERISH)"[URL]
  6. Rich KA, "Neurofilament levels in CSF and serum in an adult SMA cohort treated with nusinersen", J Neuromuscul Dis, 9, pp.111~119 (2022)
  7. De Wel B, "Biochemical and clinical biomarkers in adult SMA 3-4 patients treated with nusinersen for 22 months", Ann Clin Transl Neurol, 9, pp.1241~1251 (2022)
  8. Kusnierova P, "Neurofilament levels in patients with neurological diseases : a comparison of neurofilament light and heavy chain levels", J Clin Lab Anal, 33, pp.e22948~ (2019)
  9. Hendricks R, "Establishment of neurofilament light chain Simoa assay in cerebrospinal fluid and blood", Bioanalysis, 11, pp.1405~1418 (2019)
  10. Moshe-Lilie O, "Nusinersen in adult patients with spinal muscular atrophy : observations from a single center", Neurology, 95, pp.e413~e416 (2020)
  11. De Wel B, "Nusinersen treatment significantly improves hand grip strength, hand motor function and MRC sum scores in adult patients with spinal muscular atrophy types 3 and 4", J Neurol, 268, pp.923~935 (2021)

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